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Equity – Part of Quality Care

Conscious efforts to make care more equitable are happening every day in Ontario’s health system:

In North Bay, the Nurse Practitioner-Led Primary Care Clinic is aiming to improve the patient experience for Indigenous clients by providing cultural competency training to their staff by partnering with their local Indigenous Friendship Centre to provide training in local communities’ culture and customs.

The South-East Ottawa Community Health Centre is interested in improving health outcomes and management for patients with diabetes who are new immigrants and refugees from Somalia, Nepal or Syria.

And the Tyndall Nursing Home in Mississauga is planning on incorporating a new survey question in their resident satisfaction survey to assess whether residents feel they are treated “fairly and equitably”.

These are just a few of the examples we heard about when Health Quality Ontario asked health organizations in Ontario to tell us how they were incorporating health equity into their work.

Health equity - the ability of all people to reach their full health potential and receive fair and appropriate care no matter where they live , what they have or who they are– is a strategic priority for Health Quality Ontario and widely recognized as one of the six key dimensions of quality outlined in Quality Matters. The term is easily misinterpreted and can be a challenging concept for those providing care to put into practice, but the principle is absolutely fundamental to the provision of high-quality health care.

These examples and many others were shared by hospitals, inter-professional team-based primary care organizations, community care access centres and long-term care homes as part of their annual 2016/17 Quality Improvement Plans.

It was the first time we asked these organizations to tell us what they were working on to address health equity. We plan for it to be a regular part of the reporting in the quality improvement plans.

The answers have been published in a report showing what is being done “at the coal face” to make health equity a reality for the populations these organizations serve.

This snapshot of health equity initiatives demonstrates that while some are already focusing on equity with a crystal-clear lens, the view for other organizations remains fuzzy as they strive to better define the baseline health and needs of the populations they serve, as well as what equity means to them.

We did not provide organizations with an indicator to measure health equity as we do with other dimensions of care. We found some organizations have already created their own indicators, which varied widely based on the populations they serve and the outcomes they are aiming to meet.

When it comes to health equity there is no “one size fits all” and we expect to see organizations develop customized measures to track what they are doing in this area.

Other organizations provided comments on how they are planning to address health equity, with many relating to improving language and translation services.

For example, many long-term care homes described addressing equity by offering their Resident and Family Satisfaction Survey in up to 15 different languages. And the Plantagenet Family Health Team in rural Eastern Ontario commented that, with 82% of its patients being francophone and 7.6% speaking only French, all of its physicians are bilingual, and services, programs, and documentations are in a bilingual format.

We encourage all organizations to include the dimension of equity into their quality improvement efforts. It is also the only way to achieve a high-quality health care system for all who live in Ontario.